Survival among extremely premature neonates, those born before 28 weeks of gestation, has greatly improved thanks to advances in neonatology and prenatal care and is currently between 75% and 80% in the first world. And, in turn, 75% of extremely premature babies who survive do so free of moderate or severe disability.
However, the figures are still not optimal among those born closer to the limits of viability, before six months of gestation, something that happens in more than 25.000 births in Europe each year. In cases of the most extreme prematurity, births at 26 weeks or less, survival is between 25 and 75% depending on the weeks of gestation. And a high percentage of babies who survive may present sequelae that seriously affect their brain, cardiovascular and respiratory development, among others.
According to the latest data from the WHO, complications related to prematurity, the main cause of death in children under 5 years of age, cause one million deaths annually in the world. The reason for these high data is that, before six months of pregnancy, the lungs, intestines and brain of the fetus are poorly developed.
Why does prematurity occur? Why has prematurity not decreased in the world and remains stagnant in most developed countries (in addition to being a very important problem in developing countries)? What can we do from maternal-fetal medicine to predict or prevent prematurity?
An extremely premature newborn is actually a fetus that must survive in a very unnatural environment, outside its mother's womb. The important thing is that the survival of these babies is free of serious consequences or, at least, with the least possible affectation so that they can have the greatest possible autonomy when they grow.
How does current maternal-fetal medicine deal with the birth of an extremely premature baby? How is its monitoring and treatment approached? What consequences can affect it and how do we alleviate it? What tools do doctors and families currently have at their disposal? What tools could be incorporated for the better management of these babies in the near future and to reduce the consequences of an extreme premature birth? What research and innovations are being carried out in this regard? Could an artificial placenta be a solution?
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